| Creekside Clinic, LLC | |
|
1225 W Front St Traverse City MI 49684-2317 | |
| (231) 935-0788 | |
| (231) 935-0787 |
| Full Name | Creekside Clinic, LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 1225 W Front St, Traverse City, Michigan |
| Authorized Official Name and Position | Douglas Spence (OWNER/PHYSICIAN) |
| Authorized Official Contact | 2319350788 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creekside Clinic, LLC 1225 W Front St Traverse City MI 49684-2317 Ph: (231) 935-0788 | Creekside Clinic, LLC 1225 W Front St Traverse City MI 49684-2317 Ph: (231) 935-0788 |
| NPI Number | 1558390799 |
|---|---|
| Provider Enumeration Date | 07/01/2006 |
| Last Update Date | 12/08/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558390799 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 225100000X | Physical Therapist | () | Secondary |
| 363A00000X | Physician Assistant | () | Secondary |
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